Dr Caroline Taylor
NAPC Chair
Not an original question I know, but one which those of us who have dedicated our lives to primary care continue to wrestle with. We see people every day whom we simply send back to the conditions that made them ill in the first place. We know all the evidence around prevention is compelling. We know that it improves patient outcomes and ultimately costs less. It isn’t rocket science, so why are we still not doing it?!
Part of the problem is that every system is perfectly designed to deliver the results it gets. With so many NHS success measures designed around access to medical services or biomedical interventions it can come as no surprise that the NHS ends up being reactive rather than proactive, points result in prizes!
Combined with a sense of dependency associated with us as patients being ill and vulnerable, compounded by a power imbalance weighted in the favour of professionals, investing in treating sickness trumps investing in health time after time. We all end up standing on the sidelines calling for a more “upstream approach” whilst the success measures remain unchanged resulting in increased effort going into treating illness at the cost of investing in proactive person-centred interventions that increase our health & wellbeing.
One simple measure that improves our health & well-being is being more activated to engage with the changes needed to help stabilise our existing health and to reduce the risk of future ill health. Whilst the reasons for lower levels of activation amongst the population might be complex the reality of increasing them improving our health is overwhelmingly simple. If only we could measure it, might we then have a national health score for the NHS?
The good news is that with just a few simple questions it is possible to establish a baseline score, which could easily be linked to a person’s electronic GP record.
How might we then increase people’s sense of activation?
We could use the NHS app and make it properly useful with significantly more self-care resources, imagine if this were the ‘go to’ for health information rather than Dr Google?!
Develop some simple engaging games, videos, podcasts and articles that teach and support self-care and condition management. Individuals could see their score increase when they log on, complete a game, watch a podcast or video and even earn rewards.
For competitive types (like me!) we could see how we benchmark against others and the improvement we experience could be the only reward we need? It’s possible that others would like to see their healthy life expectancy increasing but some will only be motivated by more tangible rewards. But given the cost to the system of non-activated
behaviours such as smoking, if we could reduce acute activity costs by encouraging an individual to quit we could fund those more tangible rewards, which would of course be healthy and mindful and attractive…
What would your reward need to be to activate you to increase your National Health Service Score?
